It's All Political

November 1, 2016

(page 4 of 6)

ILLUSTRATION BY ADAM DOYLE

By David Leffler

​Over the past 15 years, Austin has earned a reputation across the country for its music festivals, bar crawls, tech startups, and fitness groups. But as the city has ballooned—estimates now put the greater Austin area at a whopping 2 million people—local government officials have made it a priority to ensure the city’s ever-increasing population is given the proper tools to lead healthy lifestyles. But that’s easier said than done.

To identify ways to improve Austinites’ quality of life, the city has partnered with a variety of community actors and health providers, including the St. David’s Foundation, the Seton Healthcare Family, and Capital Metro. Together, they’ve targeted obesity, access to healthy foods, and transportation as some of the largest areas for improvement, backing a variety of initiatives to tackle these broad issues. One of this coalition’s most notable endeavors is the Community Health Improvement Plan (CHIP), which serves as a blueprint to prioritize and address the most pressing needs of local communities. With this plan in hand, these organizations made it their mission to improve Austin’s wellness and overall quality of life.

To better understand this massive undertaking, we turned to Dr. Philip Huang, the medical director and health authority for the Austin/Travis County Health and Human Services Department. He also serves on the executive committee of the Mayor’s Health & Fitness Council, an assembly of the city’s top health and policy officials created to make Austin more active, healthy, and tobacco-free. The first thing he established during our interview together is the scope and magnitude of the public health problems the city is confronting. “As a doctor, you’re addressing issues as they arrive at your doorstep and prescribing treatments in an isolated environment. With public health, your patients are the entire community,” he said. “When you make a diagnosis, you’re looking at data and trends spanning across every sector of our society.”

In public health, identifying issues is much simpler than coming up with solutions. After all, determining that Travis County adults struggle with obesity requires surveying the local population and statistical analysis—but implementing programs and coming up with solutions takes time and patience. “We can throw different initiatives at those problems and contribute to changes in their significance within Austin, but attributing the push factors behind improvements is far more complex,” Huang said.

It makes sense exercise and diet are affected by education, social norms, personal habits, proximity to healthy and affordable foods, and transportation—just to name a few. And, as this issue’s “Roadmap of Austin” shows, accessibility and opportunity aren’t evenly distributed throughout the city. Unsurprisingly, neither are obesity, disease, and overall health. For instance, statistics show that black residents in Austin are twice as likely to die from cancer than their white neighbors. They’re also more than three times as likely to suffer from diabetes. One component of this is that Austin areas lacking easy access to affordable, nutritious foods—a phenomenon known as food insecurity—are predominantly home to people of color.

Changing people’s environment has to be the goal, Dr. Huang said. By building healthy options into residents’ daily lives and making healthier choices the easy choices—like removing soda vending machines and replacing them with less sugary drinks—you can start making unhealthy habits inconvenient. Of course, that’s just one example of a small fix for a massive problem. To keep things in perspective, Dr. Huang drew on one of the city’s biggest successes: reducing tobacco usage in Austin.

More than 20 years ago, Austin took its first major step towards this goal when it banned smoking in restaurants. City leaders expanded on this in 2005, making it illegal to smoke inside bars. In both instances, local businesses reacted defiantly, labeling these laws political overreaches that would do more harm than good. And now? “It’s like smoking was never allowed in these establishments in the first place. Imagine how shocked you be if you saw someone smoking at the table next to you these days,” Dr. Huang said with a smile. “Everything seems crazy the first time around, but the shock wears off, and people continue with their day-to-day routine—just in a safer, healthier environment.”

But it’s not just about policy. Addressing ubiquitous social issues requires a radical cultural shift in the workplace. To encourage healthy practices around the office, the Mayor’s Health & Fitness Council created the Partner Certification Program, a workplace wellness program businesses can participate in if they uphold the council’s healthy practice principles. The list of certified companies include the Capital Metropolitan Transportation Authority, The University of Texas at Austin, Dell, and National Instruments, all of which have seen the percentage of their employees who smoke drop significantly since implementing the program’s tobacco-free campus restriction. Dr. Huang pointed to this as a clear example of what happens when you change an environment to make unhealthy choices less convenient. “You can give somebody a brochure saying, ‘Smoking’s bad for you,’ but what truly alters behavior are social norms and the physical structure around you,” he said. “Smoking becomes a lot more difficult when you have to cross the street to light up.”

Reducing obesity and improving nutritional food options is a bit trickier. Over the past few years, the city has implemented programs to increase the number of healthy corner stores and is exploring ideas like mobile farmers’ markets to make buying nutritional foods more convenient to all Austin residents. The Mayor’s Health & Fitness Council is also close to introducing a “Healthiest Workplace Competition” to encourage businesses of all sizes to improve their health-related workplace practices. But as mentioned earlier, health and nutrition isn’t just a geographical or personal choice issue—it’s directly tied to socioeconomic status. To truly combat these underlying factors, Dr. Huang believes Austin will need to make a more concerted effort to break the cycle of poverty and raise the standard of living for its most disadvantaged residents. Only when more programs are in place to provide better workforce development and opportunities for social mobility will the city be truly equipped to address its residents’ largest problems.

Despite the challenges ahead, Dr. Huang is confident Austin’s policy makers have a winning plan in place. Rather than trying to treat each individual ailment our city faces—like a doctor in a one-on-one consultation with a patient—he and his colleagues are focused on raising the quality of life for all citizens by creating environments that foster healthy social norms in school, at work, in transit, and at home. If history has taught us anything, he argues, it’s that nothing is impossible. “Whether it’s smoking legislation or the Civil Rights Act, there’s always a way to clear the hurdles in front of you, regardless of their height. You can change the world, but you have to be persistent and believe in what you’re doing.”